Munlipal Form No, 102 {(To.be accomplished In quadruplicate using black nk) (Revised August 2016) Republic of the Philippines OFFICE OF THE CIVIL REGISTRAR GENERAL CERTIFICATE OF LIVE BIRTH Province BATANGAS Registry No. Gity/Munioipatty AN a 2023-113 | NAWE ‘iciey Tay |RICARDO BAYONA VERGARA 2, SEX(Male/ Female) 3, DATEOF ayy etn) ‘(ear | MALE BIRTH 07 FEBRUARY 1928 [PLAGE OF —~ [Nene grregpigcingaasea— ~~ eibinaniepatigy — (rovinesy — i BIRTH BRGY. dbieioat® se) __UAN _BATANGAS b/s Yreorsmm SBE MAPLE BIRTH, CHLOWAS | Bo BIRTH ORDER Gor toxom » Jeera Tin Te te. (Fre, Seoond, Ths, verging SINGLE norappuicase | SSRN) TMADEN, Fis) ide) l_ME ANICETA VILLAJUAN BAYONA HP @,RELIGIONRELIGIOUSSECT 9 ALBANS" ROMAN CATHOLIC | #00 Ya aber | 00 Son. | OSCURRTON 12 AaEte rete | B | eaggreomae | "hha nye tbe | See HOUSEKEEPER, OWN HOME tere Rh ia ReSiENCE Gus N.S, Barangay) (Givin Prowieay Goinigy IBRGY. BUNGAHAN LIAN BATANGAS PHILIPPINES a a ta F TELESFORO ‘SONGCO ‘VERGARA A | craenstie (TE RELGIONURELIGIOUS SECT ~~ [17, OCCUPATION 18. HE aie Ee fe T [FILIPINO ROMAN CATHOLIC “ARMER er cores yea) H 30 E [Aa RPRIDENGE | (House Nc, St, Barman) (iyMunicay (Provines) (County) R |BRGY. BUNGAHAN AN BATANGAS PHILIPPINES [MARRIAGE OF PARENTS crt ari, azonplo Ada o AcknowedgarertAcrinion of Patwny atm bac) j208, DATE (Wonthy (Day) (Year), ‘20b,PLACE (City / Municipality) (Province) FORGOTTEN INOT APPLICABLE leis. ATTENDANT — a ee 2 1 Phyiclan 2 Nurse 3 midwfo_™ 6 Hlok Tada! Binh Atandant) 6 there (Spey) bb. CERTIFICATION OF ATTENDANTAT BIRTH vce, An, Tatonl Sieh Atenas) | hereby cory hat | ated the bth of he child who wae Bom ave st famipm_ on the date fbn epected above (QECEASED AT THE TIME OF REGISTRATION) Signature — Address BRGY. BUNGAHAN, LIAN, BATANGAS Nae nt ON Tie of Postion Es pate _ NOTAPPLICABLE - |22. CERTIFICATION OF INFORMANT | 23, PREPARED BY |Inereby cert that all information supplied are true and cot ne Signature Haast . RIMAS VERGARA: MERCADOg Name In Print eons big LBEMARASAANNQTATIONG, (For LCRO/OCRG Use O: [TO BE FILLED-UP AT THE OFFICE OF THE CIVIL REGISTRAR Peraferatrsrre rsy